Thursday, March 2, 2017

Lawmakers outraged over lack of investigation in nursing home complaints

The numbers of nursing home complaints that are not fully
investigated have left Minnesota lawmakers quietly shocked and outraged.

The Minnesota Health Department performed on-site
investigations of just 10 percent of the 3,400 complaint allegations it
received from the public about nursing home and home-care treatment last
year, according to the agency’s statistics.

And when nursing homes or other facilities self report
allegations, the numbers from fiscal year 2016 were even lower. The
agency only did on-site inspections of 102 allegations — less than 1
percent — of the nearly 21,000 allegations it received from providers’
reports.

“This is one of the worst performance reports I’ve heard in
my 18 years,” Sen. Jim Abeler, R-Anoka told state officials. “As a state
we are failing with this….I don’t often get shocked anymore but you
caught my attention.”

MN Commissioner of Health Dr. Ed Ehlinger

In committees and subsequent interviews, the agency agreed the numbers deserve attention.

“It is a high priority. This is an issue that we’ve had to deal with,” Health Commissioner Ed Ehlinger told the Pioneer Press.

The number of vulnerable adults receiving care and the ease
of lodging complaints have both grown in recent years, resulting in an
exponential increase in the number of complaints the department takes
in.

In 2010, the state’s Office of Health Facility Complaints
received fewer than 500 maltreatment complaints from the public. Last
year, that number was nearly 3,500. Six years ago, providers reported
3,100 possible issues. Last year, they reported almost 20,800.

The influx has prompted the agency to triage the complaints
that come in. Complaints of actual harm, potential for harm or
widespread problems which could lead to immediate jeopardy quickly rise
to the top, said Assistant Health Department Commissioner Gil Acevedo.

But that leaves the department unable to immediately attend to other issues.

“Thousands of complaints are not investigated so
maltreatment continues, and less severe issues may escalate to more
serious harm,” the agency said in a budget request this year. Those
uninvestigated complaints in the last year included more than 4,000
falls, nearly 2,000 complaints of emotional or physical abuse by staff
and nearly 3,000 “unexplained injuries,” the department said.

“We know that this is not acceptable,” Acevedo told a senate
committee. “The volume of complaints that are coming in pretty much
overwhelms our staff.”

TIME DELAY

Even when the agency does an on-site investigation, the process takes a while.

“Because of the time it takes to complete investigations,
the public does not know about complaints occurring in facilities where
their loved ones live,” the agency said in its budget request.

Acevedo highlighted for a senate committee a case the state
looked into last year, from a Gracewood senior living facility in Hugo.

From the investigative report on the incident: “A white
powdered substance was spread under the client’s nose and the same white
powdered substance was on the table placed in three straight lines.
Client #2 was experiencing arm tremors. The song ‘Cocaine’ by Eric
Clapton was playing in the background.” The white powder, it was
discovered, was powdered sugar.

That resident was suffering from Alzheimer’s disease and
“was unable to report maltreatment due to severe memory impairment,” the
investigative report said. But a staffer at the facility recorded the
incident and shared the video.

In another incident, a client was recorded on the toilet and
yelling “you guys are going to hell” at a staffer, and a staffer yelled
back “we’ll see you there.” In a third recorded and shared incident, a
client was videotaped holding an empty alcohol bottle “while another
unidentified staff member was pushing the client’s wheelchair, with
‘rock music’ playing the background.”

“The facility was aware about this but did nothing to correct it,” Acevedo told senators.

But the report raised questions.

Sen. Karin Housley, R-St. Marys Point

“You said that complaint came in May,” Sen. Karin Housley,
R-St. Marys Point, asked the assistant commissioner at the committee
meeting.

Although the state took months to publicly post the report,
Hugo Graceland did not wait for action, according to Kari Bina, regional
director for the group that operates a dozen Minnesota assisted living
facilities, including Hugo Gracewood.

“We didn’t find out about this incident until the state
walked through our door,” she said. Once the state officials arrived in
June, the facility conducted its own investigation and “staff members
that were involved were terminated immediately.”

NEXT STEPS

As the number of complaints rose and the percentage of state
officials who could investigate declined, the state took steps to
address some of the issues.

The state changed the leadership of the office overseeing
investigations, began work to streamline the investigation process and
adopted new methods to help prevent problems.

“We recognize that we have not been able to meet the needs
that are there in the community. We recognized it several years ago and,
actually, it has led to some major changes,” said Ehlinger, the health
commissioner.

Patti Cullen, president and CEO of Care Providers of
Minnesota, which represents nursing homes and other care and housing
providers, said the providers see the need to increase the state
complaint-investigation work.

“We’re supportive of that, even if there are going to be increased fees on our people,” she said.

Sen. Jim Abeler, R-Anoka

Abeler, the state senator from Anoka and a longtime expert
in health and human services, said he was not sure that increasing the
budget would solve the problems.

“I don’t think they use the money they have well,” he said.

Meanwhile, the state will continue to work to improve.

“We are far from where we need to be,” Ehlinger told senators. “We are far from where we want to be.”

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